scholarly journals Cardiopulmonary exercise testing in systolic heart failure: from basic to advanced practice

2016 ◽  
Vol 86 (1-2) ◽  
Author(s):  
Ugo Corrà
Keyword(s):  
Exercise Testing ◽  
Objective Assessment ◽  
Cardiopulmonary Exercise Testing ◽  
Systolic Heart Failure ◽  
Objective Measure ◽  
Invasive Procedure ◽  
Computer Assisted ◽  
Non Invasive ◽  
Cardiopulmonary Exercise ◽  
Technological Advances

Cardiopulmonary exercise testing (CPET) is a specialized subtype of exercise testing that provides a more accurate and objective measure of cardiorespiratory fitness (CRF). CPET relies on measurement of ventilatory gases during exercise, <em>i.e</em>., a non-invasive procedure that involves the acquisition of expired ventilation and concentrations of oxygen (O<sub>2</sub>) and carbon dioxide (CO<sub>2</sub>) during progressive exercise. The non-invasive measurement of ventilation and expired gases permits the most accurate and reproducible quantification of CRF, a grading of the etiology and severity of impairment, and an objective assessment of the response to an intervention. Moreover, a particularly large volume of research has been directed toward the utility of CPET as a prognostic tool; CPET is a scientifically sound and therefore clinically valuable method for accurately estimating prognosis in various disease states. Although still underutilized, CPET has gained popularity not only due to the recognition of its clear value in the functional assessment of patients with cardiovascular, pulmonary and musculoskeletal disease/disorders, but also because technological advances (<em>e.g.,</em> rapid response analyzers and computer-assisted data processing) have made this modality easier to use.

Relationship between non-invasive haemodynamic responses and cardiopulmonary exercise testing in patients with coronary artery disease

2014 ◽  
Vol 36 (2) ◽  
pp. 92-98
Author(s):  
Milena Pelosi Rizk Sperling ◽  
Flávia Cristina Rossi Caruso ◽  
Renata Gonçalves Mendes ◽  
Daniela Bassi Dutra ◽  
Vivian Maria Arakelian ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Non Invasive ◽  
Cardiopulmonary Exercise ◽  
Artery Disease

Cardiopulmonary exercise testing as non-invasive tool for CTEPH treatment effect assessment

2021 ◽  
Author(s):  
Maria Simakova ◽  
Irina Zlobina ◽  
Aelita Berezina ◽  
Konstantin Pishchulov ◽  
Narek Marykyan ◽  
...  
Keyword(s):  
Exercise Testing ◽  
Treatment Effect ◽  
Cardiopulmonary Exercise Testing ◽  
Effect Assessment ◽  
Non Invasive ◽  
Cardiopulmonary Exercise

scholarly journals Publisher Correction: The Value of Cardiopulmonary Exercise Testing in Determining Severity in Patients with both Systolic Heart Failure and COPD

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Cássia da Luz Goulart ◽  
Polliana Batista dos Santos ◽  
Flávia Rossi Caruso ◽  
Guilherme Peixoto Tinoco Arêas ◽  
Renan Shida Marinho ◽  
...  
Keyword(s):  
Heart Failure ◽  
Exercise Testing ◽  
Cardiopulmonary Exercise Testing ◽  
Systolic Heart Failure ◽  
Cardiopulmonary Exercise

scholarly journals Utility of Cardiopulmonary Exercise Testing (CPET) in the Post-COVID-19 Context: Retrospective Analysis of a Single Centre Experience.

2021 ◽  
Author(s):  
Edward Parkes ◽  
Joanna Shakespeare ◽  
Timothy Robbins ◽  
Ioannis Kyrou ◽  
Harpal Randeva ◽  
...  
Keyword(s):  
Exercise Testing ◽  
Objective Assessment ◽  
Cardiopulmonary Exercise Testing ◽  
Clinical Information ◽  
Pulmonary Vascular Disease ◽  
Single Centre ◽  
Exercise Limitation ◽  
Cardiopulmonary Exercise ◽  
Single Centre Experience ◽  
Single Centre Study

Abstract Cardiopulmonary exercise testing (CPET) allows objective assessment of a patient’s global response to maximal incremental exercise. CPET has been proposed to have a role in investigating post-COVID syndrome. However, CPET is resource intensive, and essential for restoration of other clinical services (e.g. cancer surgery). The aim of this study was to explore utility of CPET in assessing functional status of COVID-19 survivors with persistent dyspnoea. Of the 600 patients reviewed in a post-COVID-19 assessment clinic between May 2020 and April 2021, 12 (male/female: 8/4; age: 4±15.2 years; BMI: 32.8±5.9 kg/m2; non-smokers/ smokers: 8/4) were referred for CPET due to persistent breathlessness out-keeping with disease severity. Of these patients, 10 patients demonstrated reduced peak VO2, whilst five had an exercise limitation attributed to physical deconditioning. Two patients had mainly a cardiac limitation to exercise, with a further three patients demonstrating breathing pattern disorder, pulmonary vascular disease and lung disease. The findings of this single-centre study suggest that intensive CPET testing may not add substantial additional clinical information to aid patient investigation/management in the context of post-COVID. Such resource intensive procedures may be better utilised in selected patients and in the restoration of NHS services following the COVID-19 pandemic.

scholarly journals Clinical Interpretation of Cardiopulmonary Exercise Testing: Current Pitfalls and Limitations

2021 ◽  
Vol 12 ◽  
Author(s):  
J. Alberto Neder ◽  
Devin B. Phillips ◽  
Mathieu Marillier ◽  
Anne-Catherine Bernard ◽  
Danilo C. Berton ◽  
...  
Keyword(s):  
Exercise Testing ◽  
Work Of Breathing ◽  
Cardiopulmonary Exercise Testing ◽  
Peak Oxygen Uptake ◽  
Exertional Dyspnea ◽  
Non Invasive ◽  
Cardiopulmonary Exercise ◽  
Direct Measurements ◽  
Severe Impairment ◽  
End Tidal

Several shortcomings on cardiopulmonary exercise testing (CPET) interpretation have shed a negative light on the test as a clinically useful tool. For instance, the reader should recognize patterns of dysfunction based on clusters of variables rather than relying on rigid interpretative algorithms. Correct display of key graphical data is of foremost relevance: prolixity and redundancy should be avoided. Submaximal dyspnea ratings should be plotted as a function of work rate (WR) and ventilatory demand. Increased work of breathing and/or obesity may normalize peak oxygen uptake (V̇O2) despite a low peak WR. Among the determinants of V̇O2, only heart rate is measured during non-invasive CPET. It follows that in the absence of findings suggestive of severe impairment in O2delivery, the boundaries between inactivity and early cardiovascular disease are blurred in individual subjects. A preserved breathing reserve should not be viewed as evidence that “the lungs” are not limiting the subject. In this context, measurements of dynamic inspiratory capacity are key to uncover abnormalities germane to exertional dyspnea. A low end-tidal partial pressure for carbon dioxide may indicate either increased “wasted” ventilation or alveolar hyperventilation; thus, direct measurements of arterial (or arterialized) PO2might be warranted. Differentiating a chaotic breathing pattern from the normal breath-by-breath noise might be complex if the plotted data are not adequately smoothed. A sober recognition of these limitations, associated with an interpretation report free from technicalities and convoluted terminology, is crucial to enhance the credibility of CPET in the eyes of the practicing physician.

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